“They need you in room 13,″ she said when I answered the phone and I ran back to the ICU. The patient was coding and for each minute that felt like an hour, we tried, and failed, to save her. She wasn’t breathing, her heart wasn’t working, and despite the 30 people gathered in the room, in the end, she died.
Running a code, as we call it, means that someone is …
Running a code is a team sport
Josh Green’s novel — and recent film — The Fault In Our Stars (TFIOS) is a new classic of young adult fiction, deservedly famous, and it’s easy to see why. The story is simultaneously deeply sad and really funny, mostly due to the narrator, Hazel. She is an intensely likable 16-year-old, who charms you even while she explains, stoically, that she is dying of thyroid cancer that has spread to …
The Fault in Our Stars: Should thyroid cancer be renamed?
Patients are being stuck with huge and unexpected medical care bills in circumstances where they have no say in selecting the physician who is billing them, and no way for them to know in advance which services the physicians would render or what it would cost them, says the New York Times.
Mr. Peter Drier received a “surprise $117,000 medical bill from …
There is no excuse for physicians to take advantage of vulnerable patients
“Why would an artist want to go to medical school?”
It was a good question, and one of my favorite questions asked of me during my medical school interviews. I am what one might define as an artist, and yes, I really wanted to go to medical school. I was a photographer, musician, composer, and actor. I loved the arts and they …
To be or not to be: An artist in medicine
Giving prescription refills is not quite as fun as it used to be. Years ago, we doctors would whip out our prescription pads — often sooner than we should have — and we’d scribble some coded language that pharmacists were trained to decipher. I’m surprised there were not more errors owing to doctors’ horrendous penmanship. On occasion, the Food and Drug Administration (FDA) would require a pharmaceutical company to change …
Why your doctor won’t refill prescriptions over the phone
I was on call last night.
Don’t get me wrong, this is not as bad as it sounds.
With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then …
Why do doctors still use pagers?
As the birth of our first child loomed on the horizon, I couldn’t help but worry. As a first time mother and a pediatrician, I found the uncertainly coupled with too much knowledge of all manner of possible problems particularly unsettling.
In addition to worrying about my baby’s health, I grew increasingly concerned about how I would handle the balancing act that all working mothers must perform. Having put motherhood off in order to complete …
The choice between motherhood and medicine
To put this post in perspective the pain of childbirth is said to be equivalent of amputating a finger.
The joint statement of the American Congress of OB/GYN and the American Society of Anesthesiologists sums pain control during labor and delivery quite nicely: “There is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care. In …
Why are so many people opposed to epidurals?
An advantage of being a foreigner, or a recent immigrant to be precise, is that it allows one to view events with a certain detachment. To analyze without the burden of love, hate or indifference for the Kennedys, the Clintons or the Bushes. To observe with both eyes open, rather than one eye looking at the events and the other looking …
It’s time to talk trade-offs in health care
“I’ve been with my doctor for years and years,” an elderly man, voice hoarse but lilting with fondness for his caregiver, told a nurse in the primary care clinic where I was waiting to see a doctor. “He’s fantastic.”
I was coming to the clinic for a follow-up appointment about an injury for which I’d been seen a few months prior, but neither the initial appointment nor this follow-up were with …
The problem with primary care residency programs
My journey in medicine began as a young child: I was the typical kid who knew I wanted to a be a doctor since I was a child and was thrilled when I was accepted into an 8-year college program which culminated in a medical degree. However, by the end of my undergraduate program, medicine was changing: doctors were spending less …
From PA to MD: An appreciation for physician education
My student’s voice trembled as she answered my question. “How do you think you’ve done so far?” I’d asked her. We’d been together on the general medicine inpatient ward for two weeks — the midpoint of the rotation — and as was my usual custom I was giving her feedback on her performance by first asking her to rate her performance …
How to give feedback to medical students
Primary care is essential to building a higher-performing health care system that promotes personal well-being and saves consumers and taxpayers money. Research shows that more primary care physicians in a community means lower rates of mortality, better preventive care, and fewer hospitalizations and emergency room visits.
Unfortunately, too many Americans lack easy access to primary care. Approximately 50 million Americans live in areas, mostly rural, with too few primary care physicians. …
3 ways to improve primary care access
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 59-year-old woman is evaluated for a 1-week history of increasing pain of the right foot. She recalls stepping on a nail about 1 month before her symptoms began. The patient has a 5-year history of heart failure secondary to idiopathic dilated cardiomyopathy. She has an implantable cardioverter-defibrillator, and her current medications …
MKSAP: 59-year-old woman with pain of the right foot
The Centers for Disease Control and Prevention (CDC) reported that between January 1 and May 23 of this year, there were 288 cases of measles reported in the US. That’s more than the total number of cases in any year since 2000, when measles was eliminated in the U.S..
We have got to get more people immunized.
Essentially all of the cases were linked to “importations,” cases brought in from other countries …
7 common reasons for refusing vaccines
Pretty much on a weekly basis I come across an article about how awful life is as a practicing physician. Articles focus on how unhappy physicians are with their jobs, with their hours, with their pay or with health care reform.
After almost a decade of practice, the fact is that I like my job.
Is it perfect? Absolutely not: quite far from it, in fact. There are certainly many times when …
There is something very special about being a physician
The ALS ice bucket challenge, better known as #ALSIceBucketChallenge or #icebucketchallenge, was almost the perfect storm for viral fundraising. In my course, Designing Health Campaigns Using Social Media at Tufts University, we analyzed why the challenge went viral.
Not surprisingly, given its popularity, my students had all heard about it and watched challenge videos. About half had done it. Some researched amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, and …
The ALS ice bucket challenge: Analysis of why it went viral
The ear, nose and throat specialist who treated comedian Joan Rivers on August 28 has been identified as Dr. Gwen Korovin, a prominent New York physician who is known as a voice doctor to many entertainers and Broadway stars including Hugh Jackman and Julie Andrews.
With a physician who is an expert in airway anatomy at her side, and all the technologic advantages …
Joan Rivers’ death: What went wrong?
Michelle wrote in: “We trained my 3-year-old son approximately 3 months ago, and it’s been great. He’s been having virtually no accidents. The problem is that he’s terrified of making ‘dirty’ on the toilet. He does it in his pamper at night when he’s sleeping. He’s very verbal about it, and tells me that he’s scared to let the dirty come out. It’s really difficult to deal with because there …
When your child doesn’t poop: Solving the constipation death spiral
I have been following the progress of bedside ultrasound (using ultrasound as a diagnostic tool during my physical exam of patients) as it gets a foothold in standard medical practice since I first started learning to do it about 3 years ago. Every so often a study comes out which warms my heart as it proves that less (radiation, expense) is more in treating patients.
An article came out in the …
Emergency room doctors can safely use bedside ultrasound
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